Nicotine is a psychoactive substance, which means it can affect a person’s psychological and emotional state.

When it enters the body with tobacco smoke, it is absorbed into the bloodstream and reaches the brain within 7–10 seconds. There it binds to nicotinic receptors on neurons that respond to acetylcholine — a neurotransmitter, or carrier of nerve impulses.

Nicotine acts like acetylcholine and causes the brain’s receptors to release “pleasure hormones” and stimulants — serotonin, norepinephrine, dopamine and glutamate. Smoking therefore gives the smoker pleasure, lifts the mood, suppresses hunger and increases the activity of the cardiovascular system.

At the same time, however, tobacco dependence begins to develop.

Psychological dependence

People often stop noticing that they are smoking and how many cigarettes they smoke, yet they carry on.

The reason is that, over time, a regular smoker develops behaviour patterns and so-called “smoking rituals”. They use them to try to cope with stress or fatigue, or simply light up when bored.

All of this establishes certain behaviour, which then gradually reinforces and strengthens the smoking habit.

Physical dependence

Physical dependence on cigarettes is linked to the central nervous system’s adaptation to smoking. After smoking a cigarette, a person may find that the urge to smoke has lessened, without knowing what is happening in the brain.

With physical dependence, tolerance to nicotine develops. This shows in the absence of euphoria and relaxation after smoking. As a result, the person gradually increases the number of cigarettes smoked each day. A habit forms of smoking immediately after waking, on an empty stomach or after meals. The intervals between cigarettes shrink to 1–2 hours.

The following symptoms appear:

  • an uncontrollable urge to smoke;
  • feelings of fear and anxiety;
  • marked irritability;
  • headache;
  • difficulty concentrating;
  • increased appetite.

Genetic predisposition also plays a notable role.

Genes carry an inherited “susceptibility” linked to dysfunction of neurotransmitters in the brain, which underlies addictions, including tobacco dependence.

It is estimated that in around 50% of cases, genetic factors may contribute to the development of dependence.

Treating tobacco dependence

Behavioural therapy focuses on overcoming harmful habits and developing new, healthy ones.

Medication is indicated for all smokers with moderate to severe tobacco dependence. Its aim is to ease the withdrawal symptoms that follow stopping smoking and to prevent relapses and a return to smoking.

When you consult a specialist in overcoming nicotine dependence, the doctor will assess the severity of the condition based on the symptoms present. The more accustomed a person is to tobacco, the longer the treatment and the higher the risk of seizures.

To overcome the signs of dependence, it is advisable to see a doctor. Without specialist medical help, only 5% of people manage to give up the habit, whereas with specialist treatment 25% achieve remission lasting 3 years or more.

Treatment includes nicotine replacement therapy, using various products such as:

  • Nicotine patches;
  • Chewing gum;
  • Oral spray.

Cognitive psychotherapy is part of the medical programme. It helps people understand why they smoke, teaches them how to respond to cravings and how to avoid situations in which they may want to light up.

Effective treatment therefore requires the right psychological attitude, cooperation with a good specialist and the support of family.